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European Heart Journal. Acute Cardiovascular Care

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https://www.readbyqxmd.com/read/30516390/multisite-vascular-disease-in-acute-coronary-syndromes-increased-in-hospital-mortality-and-no-improvement-over-time
#1
Marco Roffi, Dragana Radovanovic, Juan F Iglesias, Franz R Eberli, Philip Urban, Giovanni B Pedrazzini, Paul Erne, Hans Rickli
INTRODUCTION: Limited data are available on the impact of multisite artery disease in patients with acute coronary syndromes. In particular, it is unknown whether the outcomes of those high-risk patients have improved over time. Therefore, we addressed the multisite artery disease patient population enrolled in the Swiss nationwide prospective acute coronary syndromes cohort study AMIS Plus over two decades. METHODS: All patients enrolled from January 1999 to October 2016 were stratified according to the presence of isolated coronary artery disease or multisite artery disease, defined as coronary artery disease with known concomitant vascular disease (i...
December 5, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30477317/prognostic-significance-of-emergency-department-bypass-in-stable-and-unstable-patients-with-st-segment-elevation-myocardial-infarction
#2
Karl Heinrich Scholz, Tim Friede, Thomas Meyer, Claudius Jacobshagen, Björn Lengenfelder, Jens Jung, Claus Fleischmann, Hiller Moehlis, Hans G Olbrich, Rainer Ott, Albrecht Elsässer, Stephen Schröder, Christian Thilo, Werner Raut, Andreas Franke, Lars S Maier, Sebastian Kg Maier
BACKGROUND: In ST-segment elevation myocardial infarction (STEMI) patients treated with percutaneous coronary intervention, direct transport from the scene to the catheterisation laboratory bypassing the emergency department has been shown to shorten times to reperfusion. The aim of this study was to investigate the effects of emergency department bypass on mortality in both haemodynamically stable and unstable STEMI patients. METHODS: The analysis is based on a large cohort of STEMI patients prospectively included in the German multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial...
November 27, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30468395/pre-hospital-risk-assessment-in-suspected-non-st-elevation-acute-coronary-syndrome-a-prospective-observational-study
#3
Dominique N van Dongen, Rudolf T Tolsma, Marion J Fokkert, Erik A Badings, Aize van der Sluis, Robbert J Slingerland, Arnoud Wj van 't Hof, Jan Paul Ottervanger
BACKGROUND: Pre-hospital risk stratification of non-ST-elevation acute coronary syndrome (NSTE-ACS) by the complete HEART score has not yet been assessed. We investigated whether pre-hospital risk stratification of patients with suspected NSTE-ACS using the HEART score is accurate in predicting major adverse cardiac events (MACE). METHODS: This is a prospective observational study, including 700 patients with suspected NSTE-ACS. Risk stratification was performed by ambulance paramedics, using the HEART score; low risk was defined as HEART score ⩽ 3...
November 23, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30456984/long-term-survival-after-early-unloading-with-impella-cp-%C3%A2-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#4
Tobias Loehn, William W O'Neill, Bjoern Lange, Christian Pfluecke, Tina Schweigler, Johannes Mierke, Nadine Waessnig, Adrian Mahlmann, Akram Youssef, Uwe Speiser, Ruth H Strasser, Karim Ibrahim
BACKGROUND: The use of percutaneous left ventricular assist devices in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) is evolving. The aim of the study was to assess the long-term outcome of patients with AMICS depending on early initiation of Impella CP® support prior to a percutaneous coronary intervention (PCI). METHODS: We retrospectively reviewed all patients who underwent PCI and Impella CP® support between 2014 and 2016 for AMICS at our institution...
November 20, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30449136/serum-neprilysin-and-the-risk-of-death-in-patients-with-out-of-hospital-cardiac-arrest-of-non-traumatic-origin
#5
Thomas A Zelniker, Sebastian Spaich, Jan Stiepak, Florian Steger, Hugo A Katus, Michael R Preusch
BACKGROUND: Early risk stratification remains an unmet clinical need in patients with in out-of-hospital cardiac arrest. We hypothesised that soluble neprilysin may represent a promising biomarker in patients with out-of-hospital cardiac arrest of non-traumatic origin and provide new pathobiological insight. METHODS: This pilot study was a biomarker analysis from the Heidelberg Resuscitation Registry. Serum soluble neprilysin levels on admission were measured in 144 patients with successful return of spontaneous circulation after out-of-hospital cardiac arrest of non-traumatic origin...
November 19, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30426755/intramural-haematoma-of-the-ascending-aorta-not-so-malignant-after-all
#6
Udo Sechtem
No abstract text is available yet for this article.
November 14, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30421619/reperfusion-cardiac-arrhythmias-and-their-relation-to-reperfusion-induced-cell-death
#7
Kirian van der Weg, Frits W Prinzen, Anton Pm Gorgels
Reperfusion does not only salvage ischaemic myocardium but can also cause additional cell death which is called lethal reperfusion injury. The time of reperfusion is often accompanied by ventricular arrhythmias, i.e. reperfusion arrhythmias. While both conditions are seen as separate processes, recent research has shown that reperfusion arrhythmias are related to larger infarct size. The pathophysiology of fatal reperfusion injury revolves around intracellular calcium overload and reactive oxidative species inducing apoptosis by opening of the mitochondrial protein transition pore...
November 13, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30421616/outcomes-of-medically-managed-patients-with-myocardial-infarction
#8
Padma Kaul, Anamaria Savu, Shereen Hamza, Merril L Knudtson, Kevin Bainey, Neil Brass, Paul W Armstrong, Robert C Welsh
AIMS: The purpose of this study was to compare outcomes associated with medical management of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction patients presenting to hospitals with and without onsite catheterization facilities. METHODS: All patients ( n=25,921) with ST-elevation myocardial infarction ( n=10,563) or non-ST-elevation myocardial infarction ( n=15,358) in Alberta, Canada between April 2010-March 2016 were categorized according to availability of catheterization facilities at the hospital they presented to and their management strategy (medically managed without coronary angiography or medically managed after coronary angiography)...
November 13, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30407069/cardiac-involvement-in-critically-ill-patients-with-leptospirosis-a-prospective-study-using-myocardial-deformation-imaging
#9
Anoop Mathew, Miriam Shanks, Eapen Punnoose, Louie Fischer, George Koshy, Rahul Potluri, Kevin R Bainey
BACKGROUND: Myocardial inflammation often complicates leptospirosis, a re-emerging global zoonosis. Leptospirosis associated myocardial dysfunction is equivocal and the pattern of cardiac involvement may not differ from that of sepsis associated myocarditis. METHODS: We prospectively compared cardiac involvement in 113 intensive care unit patients with severe leptospirosis to 31 patients with sepsis syndrome using a comprehensive assessment comprising of clinical presentation, electrocardiography, two-dimensional echocardiography (with global longitudinal strain calculation), and cardiac biomarker evaluation...
November 8, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30406678/survival-after-refractory-cardiogenic-shock-is-comparable-in-patients-with-impella-and-veno-arterial-extracorporeal-membrane-oxygenation-when-adjusted-for-save-score
#10
Petter Schiller, Laila Hellgren, Per Vikholm
OBJECTIVES: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. METHODS: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included...
November 8, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30406673/gender-differences-in-patient-and-system-delay-for-primary-percutaneous-coronary-intervention-current-trends-in-a-swiss-st-segment-elevation-myocardial-infarction-population
#11
Matthias R Meyer, Alain M Bernheim, David J Kurz, Crochan J O'Sullivan, David Tüller, Rainer Zbinden, Thomas Rosemann, Franz R Eberli
BACKGROUND: Women with ST-segment elevation myocardial infarction (STEMI) experience greater delays for percutaneous coronary intervention-facilitated reperfusion than men. Whether women and men benefit equally from current strategies to reduce ischaemic time and whether there are gender differences in factors determining delays is unclear. METHODS: Patient delay (symptom onset to first medical contact) and system delay (first medical contact to percutaneous coronary intervention-facilitated reperfusion) were compared between women ( n=967) and men ( n=3393) in a Swiss STEMI treatment network...
November 8, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30403366/real-life-use-of-left-ventricular-circulatory-support-with-impella-in-cardiogenic-shock-after-acute-myocardial-infarction-12-years-amc-experience
#12
Dagmar M Ouweneel, Justin de Brabander, Mina Karami, Krischan D Sjauw, Annemarie E Engström, M Marije Vis, Joanna J Wykrzykowska, Marcel A Beijk, Karel T Koch, Jan Baan, Robbert J de Winter, Jan J Piek, Wim K Lagrand, Thomas Gv Cherpanath, Antoine Hg Driessen, Riccardo Cocchieri, Bas Ajm de Mol, Jan Gp Tijssen, José Ps Henriques
AIMS: Mortality in cardiogenic shock patients remains high. Short-term mechanical circulatory support with Impella can be used to support the circulation in these patients, but data from randomised controlled studies and 'real-world' data are sparse. The aim is to describe real-life data on outcomes and complications of our 12 years of clinical experience with Impella in patients with cardiogenic shock after acute myocardial infarction and to identify predictors of 6-month mortality. METHODS: We describe a single-centre registry from October 2004 to December 2016 including all patients treated with Impella for cardiogenic shock after acute myocardial infarction...
November 7, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30403364/atrial-fibrillation-detected-initially-during-acute-medical-illness-a-systematic-review
#13
William F McIntyre, Kevin J Um, Christopher C Cheung, Emilie P Belley-Côté, Orvie Dingwall, Philip J Devereaux, Jorge A Wong, David Conen, Richard P Whitlock, Stuart J Connolly, Colette M Seifer, Jeff S Healey
OBJECTIVE: There is uncertainty about the incidence of and prognosis associated with atrial fibrillation that is documented for the first time in the setting of an acute stressor, such as surgery or medical illness. Our objective was to perform a systematic review of the incidence and long-term recurrence rates for atrial fibrillation occurring transiently with stress in the setting of acute medical illness. DATA SOURCES: Medline, Embase and Cochrane Central to September 2017...
November 7, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30387680/smoking-is-the-dominating-modifiable-risk-factor-in-younger-patients-with-stemi
#14
Hanne Bechmann Gleerup, Christina C Dahm, Troels Thim, Svend Eggert Jensen, Lisette Okkels Jensen, Steen Dalby Kristensen, Hans Erik Bøtker, Michael Maeng
AIMS: Smoking is an important modifiable risk factor for myocardial infarction. It is unclear whether smoking habits at the time of an incident ST-segment elevation myocardial infarction (STEMI) differ across age groups and sex. METHODS AND RESULTS: We included patients with incident STEMI registered in the Western Denmark Heart Registry from 2005 to 2015 ( n=9914). Patients were divided into four age groups (30-49, 50-59, 60-69 and ⩾70 years) with the latter serving as reference...
November 2, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30362813/right-bundle-branch-block-in-patients-with-suspected-myocardial-infarction
#15
Johannes Tobias Neumann, Nils Arne Sörensen, Nicole Rübsamen, Francisco Ojeda, Sarina Schäfer, Till Keller, Stefan Blankenberg, Peter Clemmensen, Dirk Westermann
AIMS: The new European Society of Cardiology guideline for ST-segment elevation myocardial infarction recommends that left and right bundle branch block should be considered equal for recommending urgent angiography in patients with suspected myocardial infarction. We aimed to evaluate this novel recommendation in two prospective studies of patients with suspected myocardial infarction. METHODS AND RESULTS: We included 4067 patients presenting to the emergency department with suspected myocardial infarction...
October 26, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30354185/atrial-fibrillation-occurring-initially-during-acute-medical-illness-the-heterogeneous-nature-of-disease-outcomes-and-management-strategies
#16
Yan-Guang Li, Marco Borgi, Gregory Yh Lip
No abstract text is available yet for this article.
October 24, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30351167/sex-related-response-to-bivalirudin-and-unfractionated-heparin-in-patients-with-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-a-subgroup-analysis-of-the-validate-swedeheart-trial
#17
D Venetsanos, S Sederholm Lawesson, O Fröbert, E Omerovic, L Henareh, L Robertsson, R Linder, M Götberg, S James, J Alfredsson, D Erlinge, E Swahn
AIMS: Our aim was to study the impact of sex on anticoagulant treatment outcomes during percutaneous coronary intervention in acute myocardial infarction patients. METHODS: This study was a prespecified analysis of the Bivalirudin versus Heparin in ST-Segment and Non ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated according to Recommended Therapies Registry Trial (VALIDATE-SWEDEHEART) trial, in which patients with myocardial infarction were randomised to bivalirudin or unfractionated heparin during percutaneous coronary intervention...
October 23, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30328697/outcomes-of-early-and-reversible-renal-impairment-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention
#18
Shafik Khoury, Gilad Margolis, Dor Ravid, Zach Rozenbaum, Gad Keren, Yacov Shacham
OBJECTIVE: Acute kidney injury (AKI) is a frequent complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). While AKI occurring post-PCI has been well studied, the incidence and clinical significance of early renal impairment evident on hospital admission prior to PCI and which resolves towards discharge has not been investigated. METHODS: We retrospectively studied 2339 STEMI patients treated with primary PCI...
October 17, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30318902/the-efficacy-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#19
Thomas A Zelniker, Christian T Ruff, Elliott M Antman, Robert P Giugliano
BACKGROUND: Patients with atrial fibrillation and concomitant coronary artery disease (CAD) are at higher risk for myocardial infarction or cardiovascular death, often require antiplatelet therapy and are therefore exposed to an increased risk of bleeding. This meta-analysis aimed to compare the efficacy and safety profile of non-vitamin K antagonist oral anticoagulants (NOACs) with warfarin in patients with atrial fibrillation and concomitant CAD. MATERIALS AND METHODS: We performed a trial-level meta-analysis of CAD subgroups from four trials of NOAC versus warfarin in patients with atrial fibrillation, comparing the primary trial endpoints (efficacy: stroke or systemic embolic event; safety: International Society on Thrombosis and Haemostasis major bleeding) in patients with versus those without CAD, and used interaction testing to assess for treatment effect modification...
October 15, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/30281320/bivalirudin-versus-heparin-monotherapy-in-non-st-segment-elevation-myocardial-infarction
#20
David Erlinge, Sasha Koul, Elmir Omerovic, Ole Fröbert, Rikard Linder, Mikael Danielewicz, Mehmet Hamid, Dimitrios Venetsanos, Loghman Henareh, Björn Pettersson, Henrik Wagner, Per Grimfjärd, Jens Jensen, Robin Hofmann, Anders Ulvenstam, Sebastian Völz, Petur Petursson, Ollie Östlund, Giovanna Sarno, Lars Wallentin, Fredrik Scherstén, Peter Eriksson, Stefan James
BACKGROUND: The optimal anti-coagulation strategy for patients with non-ST-elevation myocardial infarction treated with percutaneous coronary intervention is unclear in contemporary clinical practice of radial access and potent P2Y12-inhibitors. The aim of this study was to investigate whether bivalirudin was superior to heparin monotherapy in patients with non-ST-elevation myocardial infarction without routine glycoprotein IIb/IIIa inhibitor use. METHODS: In a large pre-specified subgroup of the multicentre, prospective, randomised, registry-based, open-label clinical VALIDATE-SWEDEHEART trial we randomised patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention, treated with ticagrelor or prasugrel, to bivalirudin or heparin monotherapy with no planned use of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention...
October 3, 2018: European Heart Journal. Acute Cardiovascular Care
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